| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $84.04 | $117.43 | $117.43 |
Cigna
| Facility | 26 | $146.88 | $171.64 | $228.13 |
Medica
| Facility | 26 | $251.32 | $251.32 | $251.32 |
Quartz
| Facility | 26 | $133.47 | $251.32 | $251.32 |